Information for Providers
Frank was born in October 2009. Frank’s old man, GMHBA, has been in the insurance business since 1934 and today is one of Australia’s most trusted health funds.
Frank is here to make health insurance less confusing, cheaper and most importantly, something members will actually use. And frankly, isn’t that the point? If you buy it, you might as well use it.
Here's what the Frank member card looks like:
GMHBA takes care of all the paperwork, leaving Frank more time to simplify health insurance. That's why Frank shares GMHBA's hospital and medical provider agreements. There are other similarities too.
Contacting Frank
If you have any questions, contact Frank on 1300 43 72 65.
Frank Health Insurance's ECLIPSE details
- Fund Brand ID: GMH
- Location ID: HSL00396
Information for hospital providers
Private Hospital Agreements
Frank members love the fact Frank has agreements with more than 480 private hospitals around Australia. The Australian Health Services Alliance (AHSA) takes care of the paperwork.
Refer to the AHSA agreement for your hospital.
If you have any questions for about Frank products or benefits, contact Frank on 1300 43 72 65.
Patient Eligibility Checks
You can perform Online Eligibility Checks (OEC) on ECLIPSE if a Frank member is being admitted to your hospital. All you need is the patient’s member number and admission details for an immediate response.
Refer to the Medicare ECLIPSE website for details on the functionality offered by each health fund.
ECLIPSE Hospital Claims
In short, billing Frank is just like sending an account to GMHBA.
You can submit Inpatient Hospital Claims (IHC) through ECLIPSE if a Frank member has been admitted to your hospital. All you need is the patient's member number and admission details.
Refer to the Medicare ECLIPSE website for details on the functionality offered by each health fund.
Information for Medical providers
Medical Provider Agreements
Frank shares GMHBA's Gap Cover Scheme. Frank agrees to pay 120% of the Medicare Benefit Schedule (MBS) fee to agreement medical providers on all service types, excluding pathology and radiology.
View a copy of the Frank MBS Schedule
Download a copy of the Frank Medical Gap Claim Account form
If you already have an agreement with GMHBA then it automatically applies to Frank. If you don’t have but want to, download the registration form here, complete and return to GMHBA by fax on (03) 5221 4582.
ECLIPSE Medical Claiming
You can submit Inpatient Medical Claims (IMC) through ECLIPSE if you've treated a Frank member as a private patient in hospital. All you need is the patient's member number and treatment details.
Refer to the Medicare ECLIPSE website for details on the functionality offered by each health fund.
Information for extras providers
If you're looking for details of Frank's Preferred, Member First, or Agreement network, you're not going to find them. Frank pays 80% or 50% of the treatment cost no matter who you are. So long as you're a registered provider of course.
Frank's members can swipe their member card to claim on the spot at any HICAPS or CSC HealthPoint terminal.
Frank participates in HICAPS Payments + Reconciliation solution and the Claims Settlement Service (CSS) for HealthPoint claims. That means payments for Frank members will be included the single settlement payment each day.